Role of the mental health professional in education and support of the medical staff

Capsule:
Reproductive counselors could broaden care to a more collaborative approach involving education, training, and support to fertility clinic staff to help reduce staff stress, prevent burnout, and improve patient care.

Authors:
Elizabeth Grill, Psy.D.

Volume 104, Issue 2, Pages 271-276

Abstract:

This review argues that mental health professionals are underutilized in the reproductive health care system. Counselors in the field of reproductive medicine could broaden their care from a strictly one-on-one patient care perspective to a more integrated and collaborative approach that also involves education, training, and support of the fertility clinic staff. The literature has shed light on reasons for patient discontinuation, but little is known about staff burnout in reproductive health care, and even less has been done to address work-related stress, job dissatisfaction, and poor emotional and physical health among fertility clinic staff. Specific educational strategies and training techniques are addressed to help reduce staff stress, prevent burnout, and improve overall patient care.

Dear Author,
we strongly agree with your paper. As in other medical areas (such as
oncology or ICU departments), fertility staff members are often exposed to
several stressing situations without an adequate training to face them. As you properly suggested, fertility clinicians are often involved in clinical encounters in
which they have to communicate a bad news (e.g., the transfer is not possible
or the ending of a treatment), but literature lacks of specific guidelines to
manage difficult conversations as in other contexts of medicine, for example in
oncology (e.g. the Six-Step Buckman protocol). As you underlined in the
article, this seems to be a lacking point also for what concerns experimental
studies about doctor-patient communication in medically assisted reproduction. We
would like to share our experience as mental health professionals and experts
in doctor-patient communication at the University of Milan, Italy. Since three years,
we are in contact with a group of infertility clinicians working all over
Italy. We have been organizing with them one day residential practical workshops
on the doctor-patient communication strictly connected with their clinical
practice and with the wonderful tool of patient-actor simulation. Thanks to the
enthusiasm of those collegues and to the willingness of create scientific evidences,
they agreed to participate to a research project that we started one year ago.
The study aimed to explore which communicational and relational aspects during
assisted reproductive technology (ART) visits facilitate patient participation
in the healthcare process and has been realized videotaping 98 ART
consultations, with the consensus of the clinicians and patients involved. The
communication content of the visits will be coded using the Roter Interaction Analysis System (RIAS). The data analysis is now ongoing and we are eager to share our results with the scientific community in order to give a contribution to this
unexplored area.

Daniela Leone (research fellow at Department of Health Sciences, University of Milan, Italy) and the teamwork.

Infertility is a very emotionally charged diagnosis for a childless couple. We are medical providers provide a lot of emotional support and empathy to help our patients get through this very difficult situation, and oftentimes we fail. We pour in our heart and soul for these patients and become vested in their diagnosis in hopes of guiding them through this process. Psychiatrists debrief after difficult situations so that they do not have to carry their mental burdens alone. Other stressful professions have regular debriefing/counseling sessions as well (i.e. police, fire, etc). We are working in an emotionally stressful environment, but do not normally have resources in place when we feel burned out. This article does a great job bringing this to light, and provides potential training and resources for improving mental health resources for providers.

We as infertility providers provide a lot of emotional support for our patients. With all of the giving, we can be emotionally drained. I think getting mental health professionals involved not only with the patients but with the clinical/medical providers is also important in keeping us from burning out.

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